Dr Bruce L Tillery DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6295 Issued in KS

Legal business name

DR BRUCE L TILLERY DDS PA

Practice address

800 Walnut St
Valley Falls, KS 66088-1238

Phone

(785) 945-6248

Fax

(785) 945-4097

NPI assigned

Aug 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce L Tillery, DDS PA

Title

Dentist Owner

Phone

(785) 945-6248

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508877507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST",
            "city": "VALLEY FALLS",
            "state": "KS",
            "postal_code": "660881238",
            "telephone_number": "785-945-6248",
            "fax_number": "785-945-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST",
            "city": "VALLEY FALLS",
            "state": "KS",
            "postal_code": "660881238",
            "telephone_number": "785-945-6248",
            "fax_number": "785-945-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BRUCE L TILLERY DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST  OWNER",
        "authorized_official_telephone_number": "785-945-6248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Valley Falls, KS
• Providers in Valley Falls, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.